Characterization of focal liver lesions using contrast-enhanced sonography with a low mechanical index mode and a sulfur hexafluoride-filled microbubble contrast agent

Xu, Hui‐Xiong; Liu, Guangjian; Lü, Ming-De; Xie, Xian-Jin; Xu, Zuo-Feng; Zheng, Yanling; Liang, Jin-Yu

doi:10.1002/jcu.20234

Cited by 80 publications

(112 citation statements)

References 27 publications

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“…This progressive neo-angiogenesis provides the clue for clinical diagnosis with imaging techniques [28] . HCC typically exhibits arterial hyper-perfusion compared with the surrounding liver tissue at the time when in the surrounding liver parenchyma no contrast effect is as yet discernible ( Figure 1) [29] . Uneven arterial hyper-enhancement of HCC may be noted, because the tumors may have septa, different cell differentiation and arterio-venous shunting patterns among the neo-formed vessels [30] .…”

Section: Detection Of Malignant Flls In Cirrhotic Liver With Ceusmentioning

confidence: 99%

“…Uneven arterial hyper-enhancement of HCC may be noted, because the tumors may have septa, different cell differentiation and arterio-venous shunting patterns among the neo-formed vessels [30] . In the portal and late phase, HCC are usually hypo-enhanced, as the UCA will wash out from HCC to the liver parenchyma rapidly, and the tumor may appear hypo-enhanced with respect to the surrounding liver in the late phase [24,25,29] . As some regenerative nodules may also exhibit additional arterial enrichment, analysis of the portal venous phase makes the differentiation of these iso-enhanced nodules from hypo-enhanced HCC possible.…”

Section: Detection Of Malignant Flls In Cirrhotic Liver With Ceusmentioning

confidence: 99%

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Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

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Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypoenhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyperenhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.

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Section: Detection Of Malignant Flls In Cirrhotic Liver With Ceusmentioning

confidence: 99%

Section: Detection Of Malignant Flls In Cirrhotic Liver With Ceusmentioning

confidence: 99%

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

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“…8,9 However, very few studies have described the imaging appearance of ICC by CEUS, and in most cases they included large tumors in noncirrhosis patients. [10][11][12][13][14][15][16] For that reason there is no accurate information regarding the appearance of ICC after CEUS in cirrhosis patients, and particularly in small nodules detected during screening. In this setting the diagnostic difficulties may be higher and, as previously mentioned, it is key to distinguish between HCC and ICC to permit a proper treatment indication.…”

mentioning

confidence: 99%

Intrahepatic Peripheral Cholangiocarcinoma in Cirrhosis Patients May Display A Vascular Pattern Similar to Hepatocellular Carcinoma on Contrast-Enhanced Ultrasound

et al. 2010

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The aim of this study was to describe the imaging features by contrast-enhanced ultrasound (CEUS) of intrahepatic cholangiocarcinoma (ICC) in cirrhosis patients. We registered the CEUS images of cirrhosis patients with histologically confirmed ICC. In all cases magnetic resonance imaging (MRI) was done to confirm the diagnosis and/or staging purposes. A total of 21 patients met all the criteria to be included in the study. The median nodule size was 32 mm. All nodules showed contrast enhancement at arterial phase; in 10 cases it was homogeneous and in 11 cases peripheral (rim-like). All nodules displayed washout during the venous phases; it appeared during the first 60 seconds in 10 nodules, between 60-120 seconds in five cases, and in six cases after 2 minutes. Ten nodules (five larger than 2 cm) displayed homogeneous contrast uptake followed by washout and they correspond to the specific pattern of hepatocellular carcinoma according to the American Association for the Study of Liver Diseases criteria. However, none of these lesions displayed washout on MRI. Conclusion : CEUS should not be used as the sole imaging technique for conclusive hepatocellular carcinoma diagnosis and if the MRI does not display the diagnostic vascular pattern, a confirmatory biopsy is mandatory. Hepatology 2010;51:2020–2029

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“…Furthermore, it was demonstrated that the diagnostic accuracy of SonoVue ® enhanced ultrasound was better in comparison to C CT and CMR [14] . Hohmann et al [15] using MBs agents in C-US with a long-lasting late phase, showed no significant difference in lesion detection compared with CMR imaging.…”

Section: C-usmentioning

confidence: 99%

Focal liver lesions found incidentally

Algarni¹,

Alshuhri²,

Alonazi³

et al. 2016

WJH

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Characterization of focal liver lesions using contrast-enhanced sonography with a low mechanical index mode and a sulfur hexafluoride-filled microbubble contrast agent

Abstract: Low-mechanical index CEUS permits real-time, complete assessment of vascularity in FLLs, which in turn facilitates their characterization.

Cited by 80 publications

References 27 publications

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Intrahepatic Peripheral Cholangiocarcinoma in Cirrhosis Patients May Display A Vascular Pattern Similar to Hepatocellular Carcinoma on Contrast-Enhanced Ultrasound

Focal liver lesions found incidentally

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